1. Field of the Invention
This invention relates to an apparatus and method for applying surgical clips, especially hemostatic clips, to body tissue such as blood vessels. More particularly, this invention relates to a surgical clip applier which can be used in laparoscopic or endoscopic procedures for closing ducts, arteries and the like, and to a method for using same.
2. Background of the Art
In surgical operations it is often necessary to apply hemostatic clips to blood vessels, and apparatus for applying clips are known in the art. See, for example, U.S. Pat. No. 4,616,650 and 4,624,254, both of which are hereby incorporated by reference in their entirety, which disclose a surgical clip applying apparatus having ring-like handles. The handles are squeezed to force jaws to move distally relative to the apparatus where they are forced together by a pair of inclined surfaces. A surgical clip between the jaws is thereby squeezed closed.
While the instruments described in the above-referenced patents have provided beneficial features to surgeons in conventional surgical procedures, they are not useful in endoscopic or laparoscopic operations. In laparoscopic procedures surgery is performed in the interior of the abdomen through a small incision; in endoscopic procedures surgery is performed in any hollow viscus of the body through narrow endoscopic tubes inserted through small entrance wounds in the skin. Laparoscopic and endoscopic procedures generally require that any instrumentation inserted into the body be sealed, i.e., provisions must be made to ensure that gases do not enter or exit the body through the laparoscopic or endoscopic incision as, for example, in surgical procedures in which the surgical region is insuffiated. Moreover, laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues, and vessels far removed from the incision, thereby requiring that any instruments to be used in such procedures be both long and narrow. In either laparoscopic or endoscopic surgery, the functional portion of the instrumentation is controlled from outside the body. Mechanical actuation of such instruments is for the most part constrained to movement of the various components along a longitudinal axis, even if lateral movement is employed at the operating site. The initial opening in the body tissue to allow passage of the endoscopic tube to the interior of the body can be a natural passageway of the body (e.g. bronchial tubes), or it can be created by a tissue piercing instrument such as a trocar. Because the endoscopic or laparoscopic tubes, instrumentation, and any required puncture are relatively narrow, endoscopic or laparoscopic surgery is less invasive and causes much less trauma to the patient as compared with procedures in which the surgeon is required to cut open large areas of body tissue.
An endoscopic apparatus for applying surgical clips is described in U.S. Pat. Nos. 5,084,057 and 5,100,420, both of which are incorporated herein by reference in their entirety. The apparatus described in these patents apply generally U-shaped or V-shaped clips fabricated from a metal such as titanium or stainless steel. The clips are positioned between the jaws of the instrument which are then closed to squeeze the clip legs together.
As an alternative to metal, polymers are also used to fabricate surgical clips. The polymers can be bioabsorbable or non-bioabsorbable. Surgical clips fabricated from polymers are described in U.S. Pat. Nos. 4,418,694; 4,476,865; 4,492,232; 4,512,345; 4,527,562; 4,557,263; 4,590,937; 4,620,541; 4,638,804; 4,646,741; and 4,741,337. Bioabsorbable polymers include, for example, homopolymers and copolymers of lactide, glycolide, caprolactone and p-dioxanone. These polymers have the advantage of decomposing in the body after a period of time. A separate operation to remove them is unnecessary. Therefore, they can be used in situations where the clip is not intended to be permanently placed in the body. Non-bioabsorbable polymers which are known to be useful for the manufacture of surgical clips include polyesters, polyamides, polycarbonates, polyvinyl chlorides, polysulfones, and polypropylenes.
Up to the present, polymeric clips have been latched, i.e. the opposing "arm" or "leg" members which clamp the body tissue lock together by means of some type of latch mechanism. More recently, another type of polymeric surgical clip has been developed which is latchless. A latchless polymeric surgical clip is disclosed in commonly assigned U.S. patent application Ser. No. 07/626,841, filed Dec. 13, 1990, herein incorporated by reference in its entirety. Up to the present, it has been desirable to develop an apparatus for applying latchless clips. The present invention provides an apparatus and method for applying such latchless clips.